Anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody positivity in recurrent aphthous stomatitis patients with iron deficiency

Authors

• Yi-Ping Wang, Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
• Yu-Hsueh Wu, Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
• Yi-Pang Lee, Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
• Julia Yu-Fong Chang, Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
• Andy Sun, Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
• Chun-Pin Chiang, Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, TaiwanFollow

Abstract

Background/purpose: Our previous study found that 101 of 430 recurrent aphthous stomatitis (RAS) patients have iron deficiency (ID). This study assessed whether all RAS patients with ID (so-called ID/RAS patients) had iron deficiency anemia (IDA) and evaluated whether the ID/RAS patients had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than healthy control subjects.

Materials and methods: The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 101 ID/RAS patients and 430 healthy control subjects were measured and compared.

Results: We found that 101 ID/RAS patients had significantly lower mean corpuscular volume (MCV), mean blood Hb and serum iron and folic acid levels than 430 healthy control subjects (all P-values < 0.05). Moreover, 101 ID/RAS patients had significantly higher frequencies of microcytosis (30.7%), blood Hb (52.5%) and serum vitamin B12 (5.9%), and folic acid (5.0%) deficiencies, hyperhomocysteinemia (9.9%), and serum GPCA positivity (10.9%) than 430 healthy control subjects (all P-values < 0.001). Furthermore, of 53 anemic ID/RAS patients, 1 (1.9%) had macrocytic anemia other than pernicious anemia, 25 (47.2%) had normocytic anemia, and 27 (50.9%) had IDA.

Conclusion: ID/RAS patients have significantly higher frequencies of microcytosis, blood Hb and serum vitamin B12 and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than healthy control subjects. Although the IDA (50.9%) is the most common type of anemia in our 53 anemic ID/RAS patients, normocytic anemia is also noted in 47.2% of the 53 anemic ID/RAS patients.

Recommended Citation

Wang, Yi-Ping; Wu, Yu-Hsueh; Lee, Yi-Pang; Chang, Julia Yu-Fong; Sun, Andy; and Chiang, Chun-Pin (2026) "Anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody positivity in recurrent aphthous stomatitis patients with iron deficiency," Journal of Dental Sciences: Vol. 21: Iss. 4, Article 26.
Available at: https://jds.ads.org.tw/journal/vol21/iss4/26

Publication Date

2026

Received Date

August 1 2026

Accepted Date

August 3 2026